Kender's Tripawd Journey

I didn’t give Kender any Buprenex last night since she seemed to be doing well all day with only her fentanyl patch, but I think that may have been a mistake.  This morning she wasn’t even trying to get up to walk…she just dragged herself with her front legs.  So I gave her a dose this morning.  When I spent time with her this afternoon, she was more mobile.

I took her out of the crate while I supervised her.  She seemed to be happy about that and walked around a little, but mostly just wanted pets.  Tomorrow I will for sure take the crate out and let her have some more freedom.

She seems to be getting back to her old self a little more.  She’s always had a crazy thwappy tail, but she hasn’t thwapped it around after her surgery until today.  Normally, it’s kind of annoying…but it was nice to see today!

Today was a pretty good day!  Kender still isn’t moving around a whole lot, but I think that’s better for her so early on.  She’s getting lots of healing rest.  I might get rid of the crate tomorrow and just give her free reign of the room. Her pain seems to be controlled really well with the fentanyl patch.  The first night home the vet suggested giving her the Buprenex also to make sure she wasn’t in pain and then to watch for signs of pain after that.  She has seemed ok, but I’ve been giving her a dose before I go to bed at night to be sure she isn’t in pain during the night when there’s no one to notice.

She’s eating lots of dry food now and totally ignored the wet stuff I brought her today.  Drinking a good amount of water too.  She’s such a weird cat…never really been into cat treats and will very rarely eat any sort of people food that most cats would like (fish, chicken, etc.)  I guess that’s better for her at this point…I have to spoil her with pets instead of fattening treats 😉

She tracked litter all over her main blanket.  When I moved her to the other one to shake it out, she immediately got up to walk back to me for more pets haha  I got a quick video of part of it and uploaded it to my fb.  But I can’t figure out how to embed it in the post like I can with my pictures, but you can click here to view it.  She also tried climbing into my lap last night, but got confused when it came to getting her back foot up on me.

While I was in petting her tonight, I folded her cone down.  After about 10-15 mins she very sneakily reached around and started licking at her stitches!  I stopped her right away, which she was quite cranky about, and put her cone back up.  But she was determined and reached right back around and started trying to lick through her cone.  Silly kitty!  Then she tried to trick me into thinking she was trying to groom her tail.  Folded her cone back down a tiny bit so she could and she went straight back to the stitches…and gave me another grumpy growl when I stopped her.  Sorry Kender…it’s better than getting stitches redone at the emergency clinic tonight!  I hope she isn’t sneaky enough to get her cone folded down when I’m not around to notice.

Today was our first day post amputation.  And I’m happy to say there isn’t a whole lot to report 😀 No news is good news, right?

When I checked on Kender this morning, her blanket was dry and there was pee in her little box.  Hooray!  No more accidents.

She wasn’t much interested in her dry food and only ate a few pieces.  I usually never buy wet food, but got her some as a special treat.  She scarfed some up when I took it to her this morning.  She wasn’t quite as interested this afternoon or tonight, but she did eat some.

She’s always happy to get pets whenever I go in to check on her.  She even enjoyed pets from the kiddos 😉  My oldest (almost 6) is concerned about her and wants to check on her 24/7.  I have to keep reminding her that the best thing for Kender right now is lots of rest, so we need to leave her alone most of the time.

I expanded her enclosure tonight also so that she has more room to try moving around in.  I plan to get rid of it in the next couple of days, but we’ll she how she’s doing when the time comes.  Her incision looks great to me!  The little pooch in her belly below her incision looks a little bigger to me today.  I know those fluid type pockets are normal after surgery, so I’m not concerned at this point.  Will be sure to keep an eye on it to be safe, though.

The vet told me how calm and relaxed Kender was being the whole time she was there.  They even contemplated not putting the cone on her.  But of course, as soon as I set her carrier in the car she started meowing and trying to get her cone off!  Within 5 minutes of being out of her carrier at home, she had her cone off…but not before spilling water all over her head in the process.  And a few minutes after that I had to stop her from trying to lick her incision.

I sat with her for a little while so she could have some cone-free time.  During which she peed and just laid there in it, like she didn’t even notice.  This worried me a tad, but it is more than likely a combo of anesthesia after effects and the pain meds.  She didn’t seem to notice much when the water spilled all over her either.  Changing her blankets and cleaning her up as best I could sure got her riled up though.

She seemed really glad to have some pets and loves for a while, purring most of the time.  My five year old came in a gave her lots of lovey pets, too.  Sadly, I eventually had to put the cone back on her so I could go get kiddos ready for bed.  I set up our video monitor we use with the toddler so that I could make sure she kept her cone on this time.  She fought with it off and on for a while, spilling her food in the process this time, but it’s stayed on and she’s been resting for a while now.  I need to give her a dose of Buprenex soon, but also feed bad about waking her now that she’s finally settled down!  But allowing her pain to get worse is no good either.  Hopefully she’ll be moving around a little better tomorrow and using the litter box.

Despite all the pictures I’ve seen on other blogs, her surgery site still surprised me a little.  Her pelvis seems far more pronounced than in the other pictures I’ve seen.  And her incision is not a single straight line like the others I’ve seen, but more of a T shape.  Also, with all the hair shaved off, I realize she’s chubbier than I thought 😉

 

I took Kender in bright and (way too) early this morning for her surgery.  They first did x-rays while I waited to check for any metastisis.  She said they looked all clear to her.

Originally, she was going to do Kender’s surgery first so she had longer to recover before coming home.  But upon further thought, she decided to do her second.  Her kidney levels were slightly elevated a few weeks ago, so she wants to give her an hour or two on IV fluids before putting her under anesthesia to minimize risks.

I should expect a call about how everything went around noonish (Pacific time), so I’ll update then!

**UPDATE**

Just heard from the vet and everything went great!  She has her pain patch on and she did a one-time antibiotic injection, at my request, so I don’t have to attempt to force Clavamox drops into her after all of this.  She is NOT good about taking medication and I was worried about having to fight her in her condition.  The Buprenex she’ll be taking is a small dose and she’s not as bad about taking that.  I can pick her up in about 3.5 hours to come home!  HUGE thanks to everyone for the emotional support today 😀

 

This seems to be my mantra lately.  They say hindsight is 20/20 and I’ve sure been shown that a lot this past month.

I wish I had….

…waited for an appointment with my usual vet and/or listened to my gut and pushed for a more definitive diagnosis when it was telling me this was not an abscess.

…not put Kender through the pain of lancing and draining an abscess that didn’t exist.

…skipped the biopsy and instead opted to have the whole leg tested post-amputation, rather than putting Kender through even more pain of a biopsy that yielded very little useful information.

I know holding onto all of this and stressing about it does nothing productive at all.  But I’ve always had a hard time letting go of the past and moving on.  Plus, seeing my poor track record so far makes me scared that the next decision I make will be another wrong one.

The oncologist suspects it’s likely histiocytic sarcoma or tarsal lymphoma.  I can find next to no literature on feline tarsal lymphoma, but the oncologist said it is something they are seeing more of recently.  The oncologist said each of these should be treated with chemotherapy in addition to amputation.  The research I’ve done shows a disparity in whether chemo is necessary for histiocytic sarcoma or not, but I’m no expert.  Of course, to do chemo we would need a definitive diagnosis to determine which drugs to use.

The vet recommends sending in the amputated leg for two reason.  One is to be certain we have clean margins.  The other is that they may be able to get a definitive diagnosis from another area.  But if they can’t, then they would have to do immunohistochemical staining to get a diagnosis.

I wish money didn’t have to play a role in all of this, but it does.  The credit cards can only take so much.  We’ve essentially “wasted” $700ish so far on antibiotics, abscess draining and the biopsy.  So I’m also faced with the decision of what to do post-amp.  Chemo or no?  If we are going to do chemo, do we test the leg for margins (how much will this matter if we are doing chemo anyway) and hope they can also get a definitive diagnosis?  Or just jump straight to the staining, which costs about $100 more than histology of the leg?

Of course, this all may be moot if the pre-op x-rays show the cancer has already spread throughout her body, which is a very real possibility with how long it’s been.

I wish I had…a crystal ball to tell the future with.

Kender’s swelling was kind of starting to worry me, so I called the vet this morning to ask about it.  She wanted us to come in to look at her just to make sure it didn’t look infected from her biopsy.  This also gave me a chance to ask questions about her surgery and recovery.  The biopsy results weren’t in yet, but she called the lab and they said she’d have them sometime today. She’s going to do Kender’s surgery first that day, so that she has all day to be observed during recovery.  They don’t have anyone there from 6 pm to 7 am so the plan is for me to bring her home that evening.  If any emergencies arise, I can take her to the after hours emergency clinic.  She’ll get hydromorphone before, during and after the surgery to help with pain and come home with a fentanyl patch on.

Just got a call with the results.  Unfortunately, they’ve left me with more questions than answers.  They classified it as a round cell sarcoma, but could not definitively diagnose the type.  Narrowed it down to synovial cell sarcoma, histiocytoma or lymphoma.  I’m really hoping it’s not lymphoma since it will likely have spread by this point.  She said they could do immunohistochemical staining to the samples to try to get a definitive answer, but the results can take up to two weeks to get back.  She’s also going to consult with an oncologist about the results and should hear back from them by Wednesday. We both still think that amputation is best at this point due to how quickly it is growing and the amount of pain/discomfort she’s in.  Plus, waiting for the staining results only gives the cancer more time to potentially spread.  For the first two types, amputation is usually considered the best course of treatment anyway.

It just dawned on me that I should have asked about doing x-rays to see if anything shows up there.  If it’s already spread all through her body and she doesn’t have much time left, amputation doesn’t seem like the best choice.  I’ll discuss that with her when she calls about the oncologist consult.

I was really starting to feel at peace about this whole thing and accepting that she had cancer, but amputation would more than likely treat it.  Now I’m back to facing the reality that my cat may need to be euthanized.  I’m ready to get off this roller coaster now.

I was really hoping we’d have the biopsy results back by Friday so I didn’t spend the entire weekend wondering about them!  But oh well, it is what it is and I’m doing my best to be patient.  Hopefully, we’ll hear back tomorrow (Monday).  I’ve also made a list of questions to go over with the vet when she calls with the results.  So I guess on the plus side, it’s given me more time to work on that.

I’ve also been working on cleaning out our spare room for Kender to be in after her surgery.  Right now it’s a combo storage/play room, so I have my work cut out for me to make it safe and comfy for her to recover in.

Her poor little paw seems to get a little more swollen every day.  It must be so horribly uncomfortable for her.  I’m glad she has some pain meds (Buprenex) to help with the discomfort.  You can see in the pic below how huge it is compared to her other one.  I know amputation surgery is a very serious operation, but I’m glad it’s an option that will (after her recovery period) relieve her of this horrible discomfort and pain.  I’ve had a cut off baby sock over the leg to keep her from messing with the stitches from her biopsy.  Most of the time she only seems slightly annoyed when I change it out with a fresh one.  But last night, when changing it, she about took my hand off.

I was so freaked out about the thought of taking off her leg before.  And I’m sure that I’ll have a mini-freak out when I actually drop her off for the surgery.  But after hearing all of the positive outcomes here and seeing how much pain and discomfort she’s in now, I wish we could just get it over with already and start on the road to recovery!  Four more days to wait…

Saw our usual vet today.  I really wish I’d just held out for an appointment with her when this whole thing started.  She always takes to the time to listen and discuss things with me.  Oh well, regret won’t help anything now.

She took some x-rays of Kender’s leg.  The bone looks really good, so not chondrosarcoma or osteosarcoma like I was fearing.  But the soft tissue looks questionable.  The vet strongly suspects fibrosarcoma at this point.  She took a few punch biopsy samples of the area to send off to the lab.  We should have the results in 2-4 business days.  The swelling in her paw is getting so much worse.  It’s most likely from the growth restricting the lymphatic system from draining.

If it’s fibrosarcoma, then amputation is usually sufficient treatment.  The vet said it can be really aggressive locally, but doesn’t usually spread to other areas. If it’s going to be cancer, then I hope it’s that because chemo and amputation is not a very realistic option. Even amputation I am iffy on since she’s so old.  I’m really nervous about doing chemo since the kids could be exposed to it, especially because Kender is notorious for not using the litter box to urinate when she is upset or not feeling well.

Her surgery schedule fills up quickly, so I made the first open appointment of 7/31/14 for the amputation in case that’s the route we decide to take.

 

My poor kitty is getting worse. Dr. Google has me strongly suspecting cancer…

Trying to get the “should’ves” and “what ifs” out of my head so I can sleep. I know they help nothing and just bring me down, but still so hard to kick them out of my head.

The area is still just as inflamed as when I first noticed it (maybe more…hard to compare now that it’s shaved), but is hotter and the rest of her leg is more swollen than before. She also favors it a lot more now…before she was walking normally. Her kidney values were also slightly raised when they did her pre-op bloodwork, which I read certain bone cancers can damage the kidneys due to rising blood calcium levels. I wish I’d just done an x-ray in the very beginning.  I know it’s really rare, even more so for females, but the whole thing has progressed almost exactly how chondrosarcoma is described. But I really hope I’m wrong cuz that doesn’t look good for her if I’m right.

I had a recheck appointment scheduled with our usual vet for 7/25, but I’m calling in the morning to see if I can get anything sooner.